1. PREVIOUS RECEPTS REPORTED FOR THIS ELECTION PERIOD
(if this is the 1st statement filed for the
primary election or an annual statement enter zero)
|
|
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$
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2. CASH CONTRIBUTIONS  
THIS PERIOD FROM:
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(A) Candidate's Own Funds |
$
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|
|
(B) Other Individuals |
$
|
|
|
(C) All Other Sources |
$
|
|
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3. LOANS RECEIVED THIS PERIOD (Schedule C, Section 1, Line 2)
|
$
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|
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4. INTEREST & OTHER INVESTEMENT INCOME THIS PERIOD
|
$
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|
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TOTAL CASH RECEIVED THIS PERIOD (Line 2(A,B, & C) Plus Lines
3 and 4)
|
$
|
|
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5. DEDUCT LOAN REPAYMENTS (Schedule C, Section 1, Line 3)
|
$
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|
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6. NET CASH RECEIVED THIS PERIOD (Total Cash Minus Line 5)
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$
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7. IN-KIND CONTRIBUTIONS
THIS PERIOD (contributions
other than cash.) FROM:
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(A) Candidate
|
$
|
|
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(B) Other Individuals
|
$
|
|
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(C) All Other Sources
|
$
|
|
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TOTAL IN-KIND CONTRIBUTIONS (To Line 15 Below)
|
|
$
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8. UNPAID PLEDGES
THIS PERIOD FROM:
|
(A) Candidate
|
$
|
|
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(B) Other Individuals
|
$
|
|
|
(C) All Other Sources
|
$
|
|
|
TOTAL UNPAID PLEDGES
|
|
$
|
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9. NET RECEIPTS THIS PERIOD (Lines 6 Plus 7 Plus 8)
|
|
|
$
|
10. TOTAL RECEIPTS FOR THE ELECTION PERIOD TO DATE (Line 1 Plus
Line 9)
|
|
|
$
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OTHER INFORMATION
|
|
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11. LOANS REPAID BY THIRD PARTIES THIS PERIOD
|
$
|
|
|
12. LOANS FORGIVEN THIS PERIOD
|
$
|
|
|